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In the past two decades, concussions have become major public health concerns. They account for 5%-9% of all sports-related injuries, particularly in contact sports, activities involving thrown objects such as balls, or those requiring special equipment such as hockey sticks or high-speed movement. Concussions affect not only competitive athletes but also women and children. The French Academy of Medicine (FAM) has addressed this in a detailed report.

Clinical Diagnosis and Symptoms

The Concussion in Sport Group describes concussions as “traumatic brain injury caused by a direct blow to the head, neck, or body resulting in an impulsive force being transmitted to the brain that occurs in sports and exercise-related activities.” The diagnosis of concussion is complex and based entirely on clinical observations. The signs are “often subtle, unstable, and non-specific.”

Warning signs include loss of consciousness, epileptic seizures, convulsions, vomiting, double vision, headaches, and neck pain. The appearance of any one of these symptoms requires immediate cessation of sports activity.

Additional symptoms such as disorientation, confusion, balance disorders, blurred or double vision, unsteady gait, poor coordination, blankness or absence, or following a moving object with the eyes also necessitate medical attention.

Protocols are available to support diagnosis and help assess potential consequences:

• Concussion Recognition Tool 6 for non-medical professionals
• SCAT6 (Sport Concussion Assessment Tool 6) and Child SCAT6 (for children) for medical practitioners

Ongoing research aims to identify specific biologic markers, particularly in the saliva.

Recovery Protocol

Symptoms following a concussion, such as neck pain, headaches, migraines, and balance or oculomotor disturbances, usually resolve on their own. However, some may persist for more than 4 weeks. Athletes return to training must be gradual.

“Competition can only be resumed after the disappearance of symptoms and recovery of the altered neurological functions, particularly cognitive; it must be authorised by trained doctors who take responsibility for the return to competition.”

Medical follow-up can be facilitated by using telemedicine, provided there is a “good network of specialists and good organisation.”

Long-Term Risks

Frequent concussions can lead to persistent mild cognitive impairments, significantly increasing the risk of Alzheimer’s disease. Other potential long-term effects include chronic traumatic encephalopathy, initially identified in boxers, which can lead to aphasia, speech disorders, dementia, Parkinson’s disease, and mood disorders. There is also a noted increase in the incidence of amyotrophic lateral sclerosis and other neurodegenerative diseases compared with the general population.

Preventive Measures

Prevention strategies include the following:

• Wearing a hard helmet offers proven protection.
• Wearing mouthguards is effective in ice hockey and likely beneficial in other sports.
• Neck-strengthening isometric exercises target the neck muscles that fix the head anteriorly, including clenching muscles, the sternocleidomastoid, and trapezius muscles.
• Athletes should be trained in sport-specific techniques to prevent injury.
• Health and sports professionals should be trained in concussion detection and management. According to the academy, this should be part of the initial and ongoing training of doctors, as well as all sports officials and coaches.

The FAM recommends establishing a teleconsultation network to assist professionals in managing concussions.

The academy concluded by reminding that this issue “concerns not only the world of competitive sports but all non-competitive and recreational sports.”

This story was translated from Univadis France using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.